Infusion set comparison

Good afternoon!
I am hoping for help & support for painful infusion set insertions. I’ve explored previous related topics and resonated with much that was shared. Thank you!

If you have experience with both Tandem’s Autosoft 30 infusion set and Minimed’s Silhouette 13 mm, would you be willing to share your experiences? Specifically, I’m interested in discomfort & pain. I have low body mass, and therefore I struggle to find comfortable locations. I also live with a chronic GI condition that makes my mid-body unavailable for insertions (at this time).

I currently use my upper thighs and upper buttocks. Many times, the insertion is painful, and it is not unusual for me to re-insert 2-3 times. When I’m able, I wait an hour before re-inserting. This can help the cannula “settle” into place, and sometimes the pain lessens and I can carry on. I also find that slow & steady breathing helps me through insertions. This allows me to relax my body & mind (that understandably fears the possible pain).

I use Minimed’s Silhouette 13 mm, and I wonder is Tandem’s Autosoft 30 infusion set could offer an improved experience. I do not use Minimed’s Sil-serter. Would you like to share your experience with this device? I’m afraid to use it because it can be difficult to let go and allow a device to take over.

I’ve considered Medtronic’s InPen because I would love a break from the insertions, but I understand that it only allows 0.50 bolus increments. I 0.025 increments in my current meal dosing.

Thanks for sharing your perspective, ideas, and lived experiences.
I appreciate you!

I use Tandem - switched from Minimed many years ago. The infusion sets are not interchangeable between the Minimed and Tandem - they were at one time but not any more. Have you tried icing the site before inserting? Some people find that helpful. And I think there are topical numbing agents you could try - your pharmacist might be able to advise you.
If you are thinking of taking a pump break can you use another pen that has the increments you need?
I hope you find a solution - please keep us posted.

Lisa @lmacuff , I may not be the best resource for you, but I have used both the Tandem and MiniMed - both the 13 mm and 17 mm - because I have a naturally high tolerance for pain. What hurts many people often will not bother me.

That said and if my memory is still working, I think the MiniMed MAY have been mote comfortable and I almost always used the inserter device. An advantage of the MiniMed is that user determines the insertion anywhere between 30 and 45 degrees. One reason I used the inserted device is that even after 65 years I always hesitate when poking in a needle and the device alloes me to just put it in place, choose my angle, close my eyes and press a button - perfect and comfortable setup every time.

Yes, sometimes after insertion and during the duration of a set I will feel discomfort especially while bolus insulin is flowing in. What I do at these times is rub around the area if itch or hurt and it usually disappears. I had tried my thighs and didn’t feel much, but because an active muscle often speeds up insulin [in me] I stay away from my legs because I take a brisk 5 mile walk most days.

Me again. Reading Dennis’s comments reminded me to add something: when I used Minimed I did use the inserter. I was trained on it and found manual insertions more intimidating. I faced my fear and inserted manually a few times but preferred using the device - as I recall I found it went quicker and success wasn’t hampered by hesitancy. Different strokes for different folks, but you could always try it and return to manual if that works better for you. If you don’t have an inserter your nurse educator/trainer/device rep might have one you could use.
Have you ever tried the 90 degree sets? Your nurse educator/trainer/device rep may have some you could try out. I switch back and forth from time to time - my doctor have me prescriptions for 90- and 30 degree sets (from Tandem) so you may not be locked in to one type.

Thank you Dorie @wadawabbit for chiming in; I admire your generous sharing. I see how you share your experiences and ideas in a compassionate, honest, invitational way. I’ve read that other individuals have tried icing their site, but I haven’t been open to this idea. I doubted it could help me, and because I often feel cold, I resisted the idea of ice … especially before a set change (I like to be warm!). However, I tried icing the area two days ago with wonderful results! Sometimes I’m afraid to hope, but I’m choosing to believe it might help again. One day, one set change at a time.

@Dennis, your experience and insight help me! I admire your kind and informative responses on this forum. Like @wadawabbit, you also offer generous ideas and support. That you for describing how you remember Tandem and MiniMed sets and insertion. I may try the MiniMed inserter. I’ve resisted insertion devices because I’m afraid of releasing control. Sometimes I don’t put the cannula the whole way in, or I pull it out if I sense deep pain. The inserter seems to eliminate these options. But … I think that it could be less intimidating, and possibly even less painful.

Thank you for sharing your thoughts, and for acknowledging my concerns! I’m preparing to start a new job with the University of New Mexico. I’ll be an Assistant Professor in the Health Sciences Library & Informatics Center. Teaching information literacy skills (including finding research evidence for evidence-based medicine/practice) & providing research support for nursing graduate students are my focus areas. I love supporting individuals (and communities) with health challenges through health literacy and information skills! I may not be as active once I begin full time work again. And it may seem I reach out with more questions that answers; but please know I’ll do my best. And I appreciate you all so much!

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@lmacuff I’m so glad to hear that icing worked for you! Change can be challenging but if you continue to have success it will become a worthwhile habit. Although you are sensitive to cold, I hope a few moments is tolerable for “the cause.”
On a side note, all the best to you in your new position! We can’t have enough information literacy so your teaching is very much needed.

You inspired me today, @wadawabbit. I wrote these words in my “One Line A Day” notebook: Change can be challenging, but if I continue to have success it can be worthwhile.

I agree … change can be very difficult. When I consider a change, it helps me to practice re-framing my thoughts in writing. First I write (to my best understanding) my negative thoughts related to the change. Then I consider a new perspective and write a second entry. This version takes a new spin on the change, and it helps me practice flexibility and imagine new possibilities. In addition to writing, I also try to approach changes in small steps, and with curiosity: “What might happen if I try this?” None of these things come naturally to me! But I do think they help me with the mental side of T1D management.

I’m an overthinker who keeps in mind worst case scenario. I try to plan for it but not dwell on it if that makes any sense at all.
A few years ago I got a very deep cavity in one of my wisdom teeth. My dentist told me he could fill it but it would be virtually all filling and I should have all four removed - they typically recommend all four at the same time to avoid shifting of the remaining teeth.
I’d had a horrific childhood dentist who left me with severe anxiety (thank God it wasn’t any other form of medical specialty!) and I was bound and determined to put it off at all costs. That filling lasted a while but it could only last so long so a couple of months ago I was told the time had come.
Waiting on insurance authorization and paperwork gave me plenty of time to imagine how bad it could be; but I finally decided to just get it over with so I wouldn’t have to think about it any more.
I scheduled the procedure for the Monday before Christmas - my gift to myself would be peace of mind. I’m a person of faith and had lots of people praying for me so in the days before - when I would ordinarily have been a nervous wreck- I was quite calm and relaxed about it. They had me in twilight sleep so I wasn’t unconscious, but what I did feel was not nearly as bad as I had always imagined it would be!
Personally I learned that the power of imagination can exceed the reality of the situation and perhaps I should just bite the bullet (with the teeth I have left😊), take a stab😊 and do the deed. Responsibly of course. So where done dreaded things comes up I’m going to try to get it over with and see how the reality compared to my imagination.
I think I’ve strayed off topic but hopefully the moderators won’t also my wrist too hard since you started it and you wrote the original post anyway😊.

Good morning @wadawabbit! Thank you for all that you shared. Your experiences and perceptions help me! The sense that our thoughts & imaginations can “trick” and “overwhelm” us resonates with me. This applies to me in many ways. The more I tend to think about something, the more I feel afraid or overwhelmed. To me, diabetes technology (like infusion sets) especially fits this pattern. The more I imagine how the insertion might go (including the possible pain), the more overwhelm I experience, and the more pain I tend to feel (something hard becomes even harder). That’s why having options to compare … different sets, devices, etc. … is so helpful to me. It helps me go from feeling stuck & afraid to having new options & ways. So thank you, everyone, for sharing your infusion set comparison with me! Technology & emotional support go hand in hand. :slight_smile:

Hello, regarding painful insertions: someone already mentioned ice as well as deep breathing. I would like to offer another thought. That would be to pre-treat the insertion site with a “Buzzy” vibrating device. They are sold various places and their home page is something like “buzzy4shots.com”.

I don’t work for Buzzy or anything like that, and of course you may like to run this by your doctor first. The Buzzy is not what I would call a cheap device, it is maybe $ 40 or so.

Lisa, this is a difficult topic as each body type will determine best fit, I have used minimed, animas, omnipod, now using tandem 9mm 90 degree infusion set. I have never had any luck with the angle canulas. I am a big fan of spring loaded injector gadgets, been using since the 1980s with syringes. The biggest factors for comfortable infusion set is site rotation and depth to get to subcutaneous layer. I always do a small Bolus dose on infusion site changes and always change every three days. If my small Bolus causes pain I first massage, pull skin around, push in, generally manipulate the site and if the canula seems to set and my sugars don’t jump all good, if not, I insert a new one, I do not waste any insulin, I just unclip at the old site and move to new site. Given your body type I would try a 6mm depth 90 degree infusion set. I will note that the omnipod automatically insertion of canula was spot on 95% of the time. It’s also good for hard to reach areas of your body. I think picking the site is 75% of the battle.

@RMcM and @Lavallek, Thank you so much for sharing these thoughts. Your experiences and options are helpful!